外周血淋巴细胞/单核细胞比值评估老年食管鳞癌患者放疗预后的价值

Value of Peripheral Blood Lymphocyte/Monocyte Ratio in Evaluating the Prognosis of Senile Esophageal Squamous Cell Carcinoma after Radiotherapy

目的:探讨放疗开始前外周血淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio,LMR)能否作为老年食管鳞癌患者预后的检测指标。方法:回顾性分析2015—2018年符合入组条件的40例患者,收集放疗前1周内的外周血常规检测结果,将其分为高LMR组(≥4.77,15例)和低LMR组(<4.77,25例)。比较两组患者的无进展生存(progression-free survival,PFS)和总生存(Overall survival,OS)情况。结果:高LMR组患者中位PFS (36个月)、中位OS (37个月)明显高于低LMR组(15个月、26个月),差异有统计学意义(P<0.05)。单因素分析结果显示,肿瘤TNM分期、LMR对患者的PFS和OS差异有统计学意义(P<0.05),是影响患者预后的危险因素。多因素分析结果显示,TNM分期、N分期、LMR是影响预后的独立危险因素。结论:放疗前LMR可以作为老年食管鳞癌患者的预后预测指标,高LMR提示患者预后较好。

Objective: To evaluate the value of peripheral blood lymphocyte/monocyte ratio(LMR) before radiotherapy in evaluating the prognosis of senile patients with esophageal squamous cell carcinoma(ESCC). Methods: A retrospective analysis of 40eligible patients from 2015 to 2018, the peripheral blood routine test results within 1 week before radiotherapy were collected, and they were divided into high LMR group(≥4.77, 15 cases) and low LMR group(<4.77, 25 cases). The progression-free survival(PFS) and overall survival(OS) of the two groups were compared. Results: The median PFS(36 months) and median OS(37months) of patients in the high LMR group were significantly higher than those in the low LMR group(15 months, 26 months), and the differences were statistically significant(P<0.05). Univariate analysis showed that tumor TNM staging and LMR had statistically significant differences in PFS and OS(P<0.05), and were risk factors affecting the prognosis of patients. Multivariate analysis showed that TNM stage, N stage, and LMR were independent risk factors for prognosis. Conclusion: LMR before radiotherapy can be used as a prognostic indicator for elderly patients with esophageal squamous cell carcinoma, and high LMR indicates a better prognosis.